Section 1
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Acute
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Cards (360)
Section 1
(50 cards)
Acute
Quick onset disease, lasts for a short period of time
Bones grow in diameter by
Osteoclasts destroying parts of the medullary cavity to enlarge it OsteoBlasts Build new bone around the outside
Metabolic
Disease caused by the disturbance of the normal physiologic function of the body (Endocrine disorders - diabetes, Fluid imbalances - dehydration)
Neoplastic disease
Disease that results in new, abnormal tissue growth Lesion - general Benign Neoplasm (well-differentiated) Malignant neoplasm (Undifferentiated) Metastatic spread -through blood, or lymph Seeding
Periosteum
Fibrouse membrane that covers bone
Additive, Sclerotic
Increase in tissue density **Results in decrease in exposure
Metaphysis
Growth zone between epiphysis and diaphysis
Apophysis
Site at which a tendon attaches to bone
What age is there more resorption than ossification
40
Trabeculae
the irregular latticework of thin bony plates in spongy bone tissue
Nosocomial
Hospital acquired disease
Dysplasia
Abnormal changes of mature cells
TNM system
Classifies cancer by T-umor size N-ode (lymph node involvement) M-etastases "Stage 0-4"
Bones in the body?
206
Ossification
Bone formation
Endemic
Diseases of high prevalence where a given causative organism is commonly found
Hereditary
Caused by developmental disorders genetically transmitted from the parent to the childs genes in chromosomes
Diaphysis
Shaft
Congenital
Disease present at brith and results from genetic or environmental factors (injury at critical point in fetal development) eg. chromosomes
Prevalence VS Incidence
Numbers of cases w/in a population VS Number of NEW cases w/in a given period
Axial Skeleton
Grading of cancer
Scale I - IV Degree of differentiation Clincal extent of tumor
Epidemiology
Investigation of disease in large groups The study of where and when diseases occur and how they are transmitted in populations
Mortality VS Morbidity rates
Avg number of deaths caused by a disease in a population (NCHS identifies trends) VS Sickness sufficient enough to interfere w/daily activities (CDC responsible for tracking)
Idiopathic
No causative factor can be identified
Epiphysis
Ends
Symptom
Patients perception
Iatrogenic
Adverse responses to the medical treatment itself
Inflammatory
Disease that results from the body's reaction to a localized agent Capillary dilation Increased capillary permeability Cellular necrosis Phagocytosis - leukocytes (Infective diseases - invasion by microorganisms, toxic diseases - poisoning by biologic substances, Allergic diseases - overreaction of bodys own defenses)
Disease
Any abnormal disturbance of the function or structure of the human body as a result of some form of injury
Hyperplasia
Increase in NUMBER of cells (tumor cells)
Metaplasia
Cell type converts to a cell type not normal for that tissue (smokers with protective lung cells)
Carcinoma
Type of caner
Cancellous bone
Spongy, porous, bone tissue in the inner part of a bone
Syndrome
group of signs and symptoms that characterize a specific abnormal disturbance
Compact bone
The outer portion of the bone
Autoimmune disorders
Disease in which the body forms antibodies that injur patient's own tissue
Sequelae
Lasting effects caused by an acute illness or Chronic illnesses with acute episodes
Degenerative
Disease caused by a deterioration of the body From traumatic injury, process of aging
Atrophy
General decrease in cell SIZE
Resorption
Bone destruction is the process of dissolving bone and returning its minerals to the bloodstream.
Medullary Canal
Inner, or central, portion of a long bone
Diploe
Spongy layer in the cranium
Epidemic
spread of disease
Chronic
manifests slowly, lasts for a long time
Subtractive, lytic, destructive
Decrease in tissue density **Results in decrease in exposure
Appendicular Skeleton
Cancer
General term for a malignancy
Sign
Detected by physician
Hypertrophy
General increase in cell SIZE
Section 2
(50 cards)
When increased function of an organ is required, what does the cell do?
Hypertrophy (Increase in cell size as a response to a demand for increased function)
Jones fracture
One of the most frequent injuries of the foot Transverse fracture at the base of the 5th metatarsal "falls of stairs or steps off curb wrong"
Which modality has superseded the use of cervical spine radiography for trauma patients
CT
What is the term commonly used to describe fractures involving the epiphysis of children?
Salter-Harris
Fracture Healing
Clot forms to bridge fracture Osteoblasts appear w/in 2-3 days Provisional callus develops approximately 1 week after fractrue Calcium is deposited in2 provisional callus forming bony callus Break is rigidly united w/in 4-6 weeks Total healing requires months
Smith fracture
Transverse fracture of wrist from falling with top of hand down, anterior displacement of radius/ulna
Osteogenesis Imperfecta (-)
Genetic Disorder causing poor development of connective tissue - resulting in brittle and easily fractured bones "Brittle Bone Disease" -may require decrease in kVp Treated by extendable rods, stem cell transplants
Neoplasia
Alterations of cell growth, specifically an abnormal proliferation of cells
Osgood-Schlatter Disease
Tibial tuberosity breaks away from the tibia due to bone development before the muscles ahve fully developed
Achondroplasia
Most common inherited disorder of the bone Results from diminished growth of cartilage in the growth plate, which impairs the lenght of the bone Appears like extreme lumbar lordosis, bowed legs, bulky forehead, midface hypoplasia, normal trunk, No cure, surgical lengthening of long bones. "Little PPL"
Cartilaginous
Amphiarthrodial Eg. Vertebral bodies
Penetrating fracture
Penetration of a sharp object
Malunion
Heals in faulty position impairing function or cosmetic appearance
Leading cause of death ages 1-44
Injury
Boxers Fracture
Transverse fracture of the neck of the 5th metacarpal Typically caused from punching
Avulsion fracture
fragment of bone pulled from shaft "chip"
Fibrous Joint
Synarthrodial eg. Skull
Complete fracture Noncommminuted
Spiral Transverse Multiple fractures Clean break
Delayed union
doesn't heal in usual time
Nonunion
bone fragments do not join often due to lack of vascularization
Level 2 Trauma center
Most common Can handle the majority of trauma cases
Diastasis
Abnormal widening of united bones - Usually immovable joint Separation of the pubic symphysis or the distal/ tib/fib
Hip dislocations are 85-90%
Posterior dislocation Most common by a severy injury - car accident - auto VS pedestrian - fall from large height
Jefferson Fracture
"Burst" fracture of C1 -atlas Severe axial compression
Dislocation
Compleate displacement of bone from its articulation
Seat Belt fracture
Synovial
Diarthrodial Eg. Knee
Odontoid Fracture
Involves junction of the odontoid and the body of C2
Most commonly dislocated joint in the body
Shoulder 95% anterior, medial
Potts Fracture
Bimalleolar frature of lower leg w/dislocation @ the ankle joint (one side transverse and the other side oblique/ spiral (Trimalleolar - involves posterior lip of tibia)
Clay shovelers fracture
Avulsion fracture of the spinous process Trauma to the posterior C-spine Muscular/ligamentous pull in flexion or extention
Common agents that cause disease include
Bacteria Chemicals Heat
Pathologic fractures
Fractures in bones that have been weakened by a preexisting condition - myeloma
Navicular fracture
Most common carpal bone fracture Transverse through mid bone
Skull fractures
Linear - straight sharply defined, radiolucent up to 0% of skull fractures are linear Depressed - curvilinear, overlapping edges (cortex into the cancellous bone) Basilar - difficult to assess w/o use of CT or MRI
Hematoma
collection of blood
Galeazzi fracture
Fracture of the shaft of the radius w/ posterior ulnar dislocation@ the wrist
Level 3 Trauma center
Provides assessment, resuscitation, and stabilization - transfers patients
Colles fracture
Most common wrist fracture slip and land on wrist Posterior dislocation of radius/ulna, anterior dislocation of carpal bones
Compression fracture (Wedge)
Most common vertebral body injury (Commonly involve the upper anterior vertebral body of thoracic/lumbar vertebrae)
Subluxation
Partial loss of joint continuity
Comminuted Fracture
Bone fragments in addition to major fracture line -butterfly -splintered
Level 4 trauma center
provides life support, basic , 24 hour lab coverage, transfers patients
Hangman's fracture
Acute hyperextension of the neck Fracture arch of C2 Anterior subluxation of C2 over c3
Greenstick fracture
Bone partially breaks and bends
The spread of cancerous cells into surrounding tissue by virtue of the close proximity best describes
Invasion
Level One Trauma center
Provides total care for all injuries
Maisonneuve Fracture
Less frequent Severe ankle sprain/disruption of the syndesmosis (immovable joint between distal tib/fib) Fracture of proximal 3rd of fibula
Bennett Fracture
Fracture/dislocation of the first CMC joint
Monteggia fracture
fracture of shaft of ulna w/ anterior radial head dislocation @ the elbow
Section 3
(50 cards)
Cystic Fibrosis
Congenital/hereditary Disease Affects exocrine glands Excretion of viscous mucus blocks the air passages , can cause infection or obstruction. Increasing life span - respiratory failure leads to death in the 40s
Malignant have what charactersitics?
Periosteal reaction, soft tissue involvement Longer than 10 cm expands bone solitary
Osteopetrosis (+)
Increased Bone Density "marble chalk, or ivory bones" Increase in bone density, but these bones are heavy,compact, and BRITTLE All bones affected, but the most significant changes are in the pelvis, long bones, vertebrae, base of skull No effective tx
Spead of bone metastases occurs in 3 ways
Proximity/direct extension Bloodstream Lymphatic system
Osteomalacia (-)
Insufficient mineralization or excessive osteoid formation of adult skeleton Appearance: -loss in density -Bowing deformities from the softened bone Can happen from excessive alchohol, insufficient nutrition Will see bright outer edges, but weaker inside
Scan VS Survey
Scan is to initially detect metastatic spread, in patients w/suspected primary site other than bones Survey is during follow-up care to check if disease is widespread
Syndactyly Polydactyly
Syn - Failure of fingers to seaparate, look webbed Poly - Presence of extra digits Need surgery
Metastatic disease
lytic and blastic, most common malignant tumor of bone Symptons include pain and pathological fracture Bones w/red marrow are most affected, because of high vasularization
MBS w/Long bones
Endotracheal Tube
ET Tube Allows free air movement Placement should be 5-7cm above carina No closer than 2cm Complications: Atelectasis (when the tube slips into the right bronchi, and overinflates it) Gastric dilation/Aspiration pneumonia - tube is too high, air goes into stomach We take a chest xray
Osteoblastoma
Larger benign tumor - simialr to osteoid osteoma, but bigger, larger than 2 cm Osteolytic - not associated w/bone growth Frequently found in the spine
Clubfoot "Talipes"
Congenital Malformation of the foot that causes the foot to turn in or out at the ankle "Varus in , Valgus out"
Metastatic bone survey VS Radionuclide Bone scan
Bone scans = best for ASYMPTOMatic Mets. Bone Surveys - done on ALL Sympotomatic sites w/patients w/ known mets ->False negatives can occur on bone scans of aggressive osteolytic lesions
Simple Bone Cyst (Unicameral)
Wall of fibrous tissue filled w/fluid - RADIOLUCENT Fluid Long bones of children
Osteomyletis (-) Tuberculosis
Mycobacterium tuberculosis commonly affects hip, knee, spine "Worm eaten" appearance Pott Disease - Tuberculosis of the spine , results in anterior wedging of the vertebrae
Ewings Sarcoma
Fairly rare, extremely malignant Affects the young, most males Arises in the medullary canal and diffuses, extensively involved in the shaft of the bone Commonly the extremities and pelvis
MBS w/ Humeri & Femurs
Gout (+)
Metabolic disorder in which uric acid crystals build up in a joint - Tophi crystal nodules More freq. in males Usually in the digits, like 1st MTP joint Caused by Kidney Failure, certain drugs, and CA
Osteoarthritis (DJD)
DJD - Degenerative joint disease "disease of age" Articular cartilage degenerates (osteophytes form) -Symptoms = stiffness, pain, limited movement, usually in the large wieght bearing joints (hip, knee, ankle) Surgery to treat, joint replacement
Most common sites of metastases
SPINE!!! - most Ribs Sternum Pelvis Skull Upper ends of humeri and femora
Fibrous Dysplasia
Proliferation of fibrous tissue w/in the Medullary Cavity - rapid growth of this fibrous tissue instead of the strong cancellous bone, which makes the bones WEAK "Soap Bubble" Look - mulitocular - or "cyst like look" -
Rickets
"juvenile" Osteomalacia Caused by a lack of vitamin D in diet or sunshine Looks like the ends of the bone are frayed, have soft pliable bones Tx - diet supplements Systematic disease that affects many body systems
Osteoma (+)
Benign, small, ROUND tumor -usually seen on the skull or sinuses SMALLER than 2mm New piece of bone growing on another, slow-growing, of little significance unless causing obstruction
Chondrosarcoma
Malignant tumor of cartilage origin Not as common as others Commonly found in pelvis, shoulder, and ribs A Bulky tumor extends and destroys bone. Can also implant/seed into adjacent soft tissue Looks like irregular/circular radiolucencies w/ areas of calcification
Osteomyelitis (-) Bacterial
Most often from staph or strep infections Commonly seen after surgery or trauma Starts as abscess of the bone, at first it is hard to see on a X-ray, looks like bone is being eaten away
Benign have what characteristics?
2-4 cm Multiple
Metastatic Bone Survey (MBS)
8 images AP Axial Towne - or Haas Lat. Skull Lat C-spine AP T-spine AP Lumbar Lat T-Spine Lat. Lumbar AP Pelvis
Developmental Hip Dysplasia
Incomplete/Malformation fo the acetabulum PEDS -> Toddlers Doctor can check by the von Rosen "frog Legs" , dislocates superiorly and posteriorly Brace is used tohold hip stable
Aneurysmal Bone Cyst
Metaphysis of long bones Numerous blood filled arteriovenous communications
Rhuematoid Arthritis
Chronic and destructive autoimmune disease Flucuates, exacerbates, and remissions Synovial tissues proliferate, destroying cartilage, bone, and supporting structures "still's disease" - juvenile form 3 TYPES - all affect the body differently
Enchondromas
Slow-growing benign tumor arising in marrow cavity Composed of hyaline cartilage Commonly affects bones of the hands and feet -ages 30-40 Easily fractured
Spina Bifida
Congenital abnormality where embryonic nueral tube fails to close completely, vertebrae doesnt form normally Can have no symptoms (spina bifida occulta) to paralysis - Can form a meningocele where meninges are forced in the gaps between vertebrae - can be fixed - Can form a Myleomeningocele where the spinal cord and meninges protrude from the body
Osteolytic Metastasis
Fast moving CA that destroys the bone w/o time for bone proliferation Bone destroying Lesion
Osteoporosis (-)
Deficiency in bone matrix - mass decreased Caused by accelerated resorption of bone due to: - aging -Post menopause - Cushing's syndrome -or someone who has not used their bone in awhile and the bones can loose that dnesit *Use a lower kVp
Osteosarcoma (Osteogenic Sarcoma)
Most common primary Malignant tumor of skeletal tissue (After multiple Myeloma) Occurs @ any age, most under 20 Occurs in Metaphysis of long bone - in marrow mostly 50% involve the knee "SunBurst" appearance Lung metasis common via blood stream Highly malignant
Osteosclerotic/osteoblastic metastases
Dense tumors in the bone Slow growing destructive CA that has allowed time for proliferation of new bone Combines destruction and hardening to create a "mottled" appearance (parts of it light up)
Avascular/Ischemic Necrosis
Disease resulting from the temporary or permanent loss of blood supply to the bones Most common in the femoral head MRI is the best imaging technicque
Osteomyelitis (-)
Infection of bone and marrow tissue, caused by pathogenic microorganism that is spread through the bloodstream Tx - antibiotics
Swan-Ganz Catheter (pulmonary artery catheter)
Used to measure pulmonary capillary pressure, cardiac output, CVP
Multiple Myeloma
Malignant tumors of bone morrow Destroys bone and produces a "punch out" appearance Most common malignant tumor Appears like metastatic CA, but more unifom in size
Ankylosing Spondylitis
Form of Arthritis that effects the spine, especially SI joints. Symptoms - back pain, fever, fatigue, weight-loss, anemia Fibrosis of the disc spaces - so spine becomes rigid "Bamboo" appearance -Bamboo Spine- Tx - meds, exercise, posture training
Scoliosis
Abnormal lateral curvature of the spine
Spondylolisthesis
Forward displacement of one of the vertebral bodys over the other Usually L4- L5
Spondylolysis
Fracture of the pars interarticularis
Common primary tumor sites from which bone metastases are:
Breast Lung Prostate Kidney thyroid Bowel
Osteochondroma (+)
Most common benign tumor Arises from the metaphysis -common in lower femur/upper tibia Looks like a bony stalk w/ a cartilage cap Asymptomatic unless trauma/pathological fracture
Pagets Disease
Common chronic metabolic disease : Destruction of bone followed by repair, which leaves the bone weakened, deformed, thickened, easily fractured Best visualized on a bone scan 1st stage - appears radiolucent - destructive phase 2nd stage - appears like cotton wool - repairative Tx w/ calcitonin to reduce bone resorption
Osteoclastoma (Giant Cell Tumor)
Numerous, mulitnucleated osteoclastic giant cells 50% Benign 35-50% Reccur 15% Malignant Affects females more than males Typically affects epiphysis of long bones "Soap bubble" appearance, begins in medullary canal, doesn't extend into joint space
Legg-Calve-Perthes' Disease
AVascularNecrosis (AVN) in children.
Osteoid Osteoma (+)
2 cm or Smaller benign Commonly found in femur, tib, spine Cortical bone - Lesion called NIDUS Sclerotic, surgery must remove nidus. - commonly "pain wakes me up at night"
Section 4
(50 cards)
COPD
Chronic Obstructive Pulmonary Disease covers: chronic bronchitis emphysema asthma
Differentiate between unicameral and aneurysmal bone cysts
Unicameral-Simple bone cyst - Wall of fibrous tissue filled w/fluid->Radiolucent fluid Aneurysmal bone cyst - Metaphysis of long bones - blood filled cysts
Difference between signs and symptoms
Symptoms - Patients perception Sign - Detected by physician
What is a Hangman's fracture
Acute Hyperextension of the neck, fracture arch of C2, anterior subluxation of C2 over C3
Most common fatal primary malignancy in the US.. 90% of lung tumors
Bronchogenic carcinoma (specific. adenocarcinoma - most common) (small cell - most aggressive)
When should an insp/exp chest exam be taken?
Pneumothorax
Dysfunction of the alveoli is associated with which COPD disease?
Emphysema
Radiographic appearance of multiple myeloma,
Has a punched out appearance
ET tube placement complications
Atelectasis Gastric Dilatation
What lung cancer is the most common primary/responsible for the most fatalities?
Bronchogenic Carcinoma - most common fatal primary malignancy (Adenocarcinoma most common cancer of this category)
Radiographic appearance of a tension pneumothorax?
On lung overinflated,one smaller?
Croup
Viral infection found in children of the subglottic region of the trachea barking cough
What is the difference between a compound and closed fracture?
Closed - didnt break skin Compound - Breaks skin
Nickname for ankylosing spondylitis
Bechterews disease, marie strumpell disease, rheumatoid spondylitis ?????
What term is given to a fracture that involves the growth plate
Salter Harris
Radiographic appearance of osteopetrosis,
Marble/chalk/Ivory bones - increased density brittle bones
PUlmonary Metastases
More common than primary lung neoplasms
What are some factors that may lead to osteoporosis?
Aging, post menopause, cushing's syndrome
Why might a bone survey be ordered?
Systomatic sites w/patients w/known mets
Thick mucus congesting airways and lungs is associated with what pathology?
Chronic Bronchiti
Term for lung collapse
Pneumothorax Atelectasis
What metabolic pathology causes bony destruction followed by a reparative phase?
Pagets disease
What lung cancer is the most aggressive?
Small Cell Lung Cancer
Radiographic appearance of fibrous dysplasia,
- Soap bubble appearance
Adult (Acute) Respiratory Distress Syndrome (ARDS)
Acute & life threatening Fluid build up in lungs due to lung beakdown Cause by signficant non-thoracic injury/disease other critically ill
Epiglottitis
Caused by an influenza can become very severe if not treated
Lung Abscess
Necrotic area of pulmonary parenchyma, containing puslike(purulent) material. - can travel up to brain
Asthma
Chommon chronic inflammation of bronchial system -Airway narrowing -Bronchial hyperresponsiveness
General term for fluid in the pleural cavity? Air?
Plueral effusion --- Pneumothorax IfYou cant see costophrenic angles, or fuzzy on bottom could be plural effusion
What diseases fall under the COPD umbrella?
Chronic Bronchitis, Emphysema, Asthma
Emphysema
Increase of air in lungs Loss of alveolar elasticity Exhalation is difficult - progressive dyspnea Abnormally radiolucent lungs Flattened diaphragm will look very dark in the lungs, less lung markings
The pathology name for bone infection
Osteomyelitis
Tuberculosis
Mycobacterium tuberculosis Can affect more than just the lungs, but it sill destroys lung tissue and replaces it with scar tissue
Hyaline Membrane Disease
Respiratory distress syndrome -deficiency of surfactant causes alveolar collapse Premies Treatment - proper thermal incubator Ventilation support/promotes
Empyema
Can be confused w/lung abscess Infection that spreads from the lung Buildup of pus in the PLUERAL space
Lesions or cavities in the apical region of the lung are typically associated with what pathology?
Tuberculosis
Pneumothorax
Air in the pleural cavity Partial or complete collapse of the lung Caused by: Trauma Spontaneous Iatrogenic Bulla rupture Seen on inspiration and expiration* Released by a chest tube higher.
What causes achondroplasia?
Most common inherited disorder Diminished growth of cartilage in the growth plate, impairs the length of the bone
What pathology is the cause of a pus-filled area within the lung?
Empyema - buildup of pus in the plueral space Lung abscess - Area of pus containing necrotic area of the lung tissue
Atelectasis
Partial collapse/ collapse of lung Decreased air in lung Reduced lung volume Caused by Neoplasm foriegn body mucous plug Compression --pneumothorax --pleural fluid --tumor --lung abscess ET Tube slippage Expiration views are helpful to visualize this.
Radiographic appearance of osteochondroma
Bony stalk w/cartilage cap
What exam is likely to be done in the ED for a patient with a suspected c-spine fracture?
Tension pneumothorax
Medical emergency A type of pneumothorax in which air that enters the chest cavity is prevented from escaping
What is a Jefferson's fracture?
Burst fracture of C1-atlas, severe axial compressions
Pleural effusion
Fluid (pus,blood) in pleural cavity Compressed lungs and causes atelectasis
A nidus is associated with what pathology?
Osteoid Osteoma
Rod-shaped bacteria that have a waxy coating, permitting existence outside the host
Tuberculosis - the mycobacterium tuberculosis
What is a type of incomplete fracture that is likely to be seen in pediatric patients?
Greenstick Fracture
Pneumonia
Bacterial or Viral Pneumococcal - antibiotics Bacterial pneumonia - staphylococcal Legionaire's disease - outbreaks occur in large buildings -heating and cooling system Bacterial can also come from aspiration Viral pneumonia - caused by various viruses
Inflammation
the body's response to injury or disease, resulting in
Section 5
(50 cards)
Myxoma
Tumor of primitive connection tissue most common primary heart tumor in adults non-cancerous
Systemic circulation
general blood circulation through the vody
Mediastinum
Anterior- thyroid and thymus Middle - heart,great vessels, esophagus, and trachea Posterior- descending aorta and spine
Tetralogy of Fallot
Most common cause of cyanosis in infants iwht cardiovascular anomalies 4 heart defects: Ventrical septal defect - septal defects are very common Pulmonary valve stenosis Right ventricular hypertrophy-trying to compensate for stenosed pulmonary valve Overriding aorta -open to both sides
SA Nodes
Are the pacemaker of the heart, located in the right atrium
Congestive Heart Failure (CHF)
-inability to provide adequate blood supply Caused by -hypertension -valvular disease - obstructive process CHF- can affect either right, left, or both sides. As pumping action is diminished, blood may back up (Acquired Vascular Disease)
Esophageal Atresia
Congenital absence or closure of normal orifice or tubular organ Esophagus fails to develop past some point Symptoms: Excessive salivation, choking, gagging, dyspnea, cyanosis Diagnosis - inability to insert NG tube No opening of the esophagus into the stomach
Rheumatic heart disease
- rheumatic fever (not common today) inflammatory changes w/in connective tissues of the body ->Valve Damage also -mitral valve -aortic valve (valvular disease)
Atherosclerosis - Atheroma formation
Fibrofatty plaques Slow narrowing Collateral blood supply
Anuerysm
Ballooning or outpouching of a vessel Saccular(portion of the wall) vs fusiform(the whole wall) aneurysm Dissecting - tear in intima Weakness in wall caused by: Atherosclerosis Trauma Infection Congenital
thrombus
blood clot
Myocardial Infarction
Acute thrombus of coronary arteries (left ventricle_ Death of heart tissue Symptoms: -sudden severe, radiating chest pain - sweating -shortness of breath -nausea -vomiting
Lateral chest - Best view of what in the heart?
Right ventricle Left atrium Heart size
During systole the heart ___________________
chambers contract
Ischemia
blood flow decreased or stopped - heart flow, decreased or stopped
Pulmonary embolism
most common lung pathology in hospitalized patients Commonly originate from deep venous system Clot or material from a distant vein that blocks a blood vessel in the lung.
PA chest radiograph is the Best view of what part of the heart?
Right atrium Left ventricle heart size
Blood flow through the heart
Deoxygenated blood comes into the right atrium, then goes down to through the tricuspid valve into right ventricle, Which pumps blood through the pulmonary valve (semi-lunar valve) into the pulmonary artery, Blood goes to the lungs, gets oxygenated, comes back through the pulmonary veins, Oxygenated blood goes into left atrium, then through the mitral valve to left ventricle, Which pumps blood through the aortic valve, then through the aorta and out to the body
Parietal peritoneum
Attached to the abdominal wall - mesentery
Valvular Disease - simple
Stenosis - Does not open fully insufficiency / Incompetency - Does not fully close (leakage) - Left side enlargement -mitral valve prolapse Endocarditis
Pulmonary Edema
Fluid accumulation in extravascular pulmonary tissues Left sided failure (acquired vascular disease)
aneurysm
localized abnormal dilation of a vessel, usually an artery
Ventricular Septal Defect
*More serious than others Hole in septal wall, Increased pulmonary blood flow, which enlarges the left ventricle/atrium
Patent Ductus Arteriosus
Passageway between the aorta and the pulmonary artery remains open after birth Mixes blood from aorta and pulmonary arteries - oxygenated and deoxygenated blood mix (congenital heart disease)
Lower repiratory system
Trachae, bronchi, lungs, alveioli
Aortic Insufficiency
Caused by: Rheumatic fever Syphilis Dissecting aneurysm Marfans syndrom Regurgitation - Dilation of left ventricle Valvular disease
Traumatic Rupture of Aorta
Potentially fatal, Rapid decelaration-shearing Blast Compression
Pulmonary circulation
circulation of blood through the lungs
During diastole the heart ___________________
chambers relax and fill with blood
Pericardium/pericardial sac
Double membranous sac that surrounds the heart
Infective Endocarditis
Nodules or vegetations on heart valves - filled with bacteria treatment - antibiotics (valvular disease)
Aortic Stenosis
Caused by : Rheumatic fever Congenital disease Deenrative Increased work for left ventricle (valvular disease)
Paranasal sinuses communicate with
the nasal cavities Are lined with respiratory epithelium
Atrial Septal Defect
MOST COMMON defect Foramen Ovale (which babys have and are supposed to close) Blood flows back intro the right atrium and returns to the lungs instead of systemic circulation (congenital heart defect)
Deoxygenated blood returns to the heart via
Inferior Vena Cava and Superior Vena Cava
Coronary Artery Disease (CAD)
atheroma deposition in coronary arteries -ischemia , blocks Angina pectoris Myocardial infarction Myocardial necrosis SINGLE most frequent cause of death in both men and women Risk factors: tobacco use poor diet poor phsical fitness Tx; anti-anginal drugs CABG
3 Tissue layers of the heart
Endocardium - inner layer Myocardium - Thickest layer (muscular,contracts) Epicardium - Outer protective covering
Coarctation of the Aorta
Ductus arteriosus (open in fetal heart, supposed to close @ birth) closes normally but creates narrowing at the junction site Blood Pressure is normal in arms and its decreased in legs ! Treated by removing the narrowed region. Congential heart disease
Left-to-right shunts
A defect causes blood mixing from systemic and pulmonary circulations. Common defects: Atrial septal defect Ventricular septal defect Patent ductus arteriosus (congenital heart disease)
Heart muscle receives blood via
Coronary arteries
Deep Venous thrombosis
Formation of blood clots in a vein Common in lower extremites -due to post-op or bed rest ifThe thrombus starts moving it turns into an embolism and can clot somewhere
Lung plueral lining separated into
Parietal pluera - covers thoracic caivty Visceral pluera - adheres to lungs **Plueral space is in between the two layers
Visceral peritoneum
Attached to abdominal organs -greater and lesser omentum hold the bowel in place
fistula
abnormal passageway between two organs or between an internal organ and the body surface
Upper respiratory system
nose,mouth,pharynx,larynx
Transposition of Vessels
Aorta arises from right ventricle instead of left - deoxygenated blood pumped back into systemic circulation Pulmonary trunk arises from left ventricle instead of right -oxygenated blood returns to lungs
Hypertension
Leading cause of stroke and CHF - normal BP 120/80
Mitral Stenosis
Seen in adults Slows blood flow Results in enlarged right side of heart and left atrium (Valvular disease)
Atherosclerosis
Hardening of the arteries -plaque build-up Decreased blood flow Most prevalent disease in humans!! Can occur in any artery Uncontrolled risk factors: -age -family history -disease processes - diabetes Controlled risk factors: -LDL, HDL -Hypertension -Smoking -Obesity -Sedentary lifestyle
Treatment CHF & Pulmonary edema
Low Salt diet Compression stockings Decrease stress -Diuretic -Digoxin -Beta-blockers
Section 6
(50 cards)
Esophageal Diverticula
Diverticulum -Pouch or sac normally occurring or created by a herniation of the mucous membrane Pulsion -composed of only mucosa and submucosa herniating through the muscular layer ->>> motility disorder ->>> upper and lower third Traction - Involve all layers of the wall ->>scar tissue - middle third Asymptomatic unless food gets stuck and obstructs the esophagus Contents may be aspirated by recumbent patients (pneumonia)
Fusion kidney
Horseshoe kidney - most common, kidneys fuse together Crossed ectopy ->kidney lies across midline and is fused with the other kidney
Herniation
Protrusion of a loop of bowel through a small opening, usually abdominal wall "rupture" Inguinal - commonly in men - Femoral Umbilical - mn and women Reducible - can be put back Incarcerated - trapped Strangulated - cut off from blood supply
Tracheoesophageal Fistula
May coincide w/ atresia Increased risk of aspiration Atresia and tracheoesophagehal fistuala incompatible with life connection between trachea and esophagus; oral intake enters trachea through fistula Can also be caused by cancer
Pyelonephritis
Inflammatory Bacterial infenction of the calyces and renal pelvis -can be caused from: -reflux of urine into kidneys -pregnancy -Catheter usage -recurrent UTI symptoms: fever,flank pain, malaise, pyuria Tx: antibiotics, control of hypertension in chronic stage
Malrotation
Incomplete or excessive rotation of the kidneys Not clinically signfificant unless obstruction occurs
Renal colic
Severe flank pain -stones?
Appendicitis
Inflammation of the appendix Results from an obstruction from a fecalith or rarely a neoplasm Complications: Gangrene Perforation/peritonitis Abscess Symptoms -RLQ pain -Nausea, vomiting -low-grade fever - sudden onset of constipation -elevated WBC
Hiatal hernia
Weakness of esophageal hiatus, permits a portion of the stomach to move into thoracic cavity Found in 50% of the population over 50 Majority are direct or sliding hernias - schatzki ring -rolling or paraesophageal hernia - potentially life trheatening - trapped blood supply affected Most are Asymptomatic Chronic herniation, leads to GERD "full feeling in chest, heartburn Trx. conervative, minimize discomfort
Most common cause of a mechanical small bowel obstruction
fibrous adhesions
Small bowel Neoplasms
incidence is surprisingly low, SB constitutes 75% of the GI tract, large mucosal surface. Symptoms - intermittent abdomen pain or cramps Endoscopy is the primary means for diagnosis Surgical resection is the primary treatment
Most common cause of a large bowel obstruction
primary colon cancer
Glomerulonephritis
Inflammation of glomeruli -may follow streptococcal infection of the upper respiratory tract or middle ear -kidneys appear larger radiogrpahically -ppl may notice edema in hands or face, blood tinge to urine or foamy urine - not filtering protein out of there tx- self limiting meds to reduce edema anti-inflammatory drug or steroid
Peptic Ulcer Disease
Peptic ulcer disease is a group of inflammatory processes involving the distal esophagus, stomach, and duodenum. NSAIDs adn H. pylori alter the mucosa Symptoms; Gastric ulcer epigastric pain radiating to all parts of abdomen Duodenal ulcer mid-moring abdomen pain
Esophageal Tumors
Leiomyomas -benign -requires surgical removal Squamous cell carcinomas -body of esophagus -spread via lymph nodes Adenoarcinomas -gastroesophageal junction -spready via lymph nodes and local metastasis
Diverticulitis
Inflammation of the diverticula -10-20% of patients w/diverticulosis symptoms: - tenderness -fever -increased WBC complications: -abscess -fistula -obstruction -perforation
Nissen Fundoplication
Surgical procedure to treat GERD and hiatal hernia. In GERD it is usually performed when medical therapy has failed
Polyps
Small benign masses that protrude from the bowel wall - potential to become malignant -> sessile - attached by a wide base --> penducnculated - attached by narrow stalk ->> left colon rectosigmoid area
Peptic Ulcers
acute ulcers are shallow and show some signs of healing chronic ulcers are deeper and have sharp margins and no necrotic tissue due the acid keeping the bottom "clean" Treatment: Bleeding Perforation Pneumoperitnoeum Peritonitis Sores, erosions, or breaks in the mucosal lining of the stomach.
Ulcerative Colitis
Inflammatory disease of the colon mucosa - unknown cause - autoimmune factor symptoms: Diarrhea containing blood, pus, and mucous Starts in rectum, spreads to sigmoid "ascends" -can affect entire colon Can be surgically fixed, because it doesnt reoccur that often Lead pipe sign* so no haustra, just smooth and tubular Ominous - toxic megacolon
Nephroptosis
Kidney is mobile and drops toward the pelvis -kidney prolapse may or may not affect the patient *After a transplant the kidney may be placed into the pelvis
Gastric Cancer
Gastric carcinoma - more commin in pyloric and antrum regions (distal stomach) - polypoid appearance -metastasize readily through bloodstream, lymphatic, and regional spread Diagnosis- upper GI endoscopy w/biospy fluoroscopic UGI series
Esophageal Strictures
Secondary to ingestion of alkalinee or acidic corrosive agents, radiation side affect
colorectal carcinoma
cancerous tumor of the colon or rectum
Bowel Obstructions
Mechanical -blockage of bowel lumen -gas confined to SB, multible air/fluid levels (could be hernia, tumor, volvulus, intussusception,adhesion) "step ladder" sign Paralytic ileus/adynamic -peristalsis failure - gas distributed through SB and LB Signs and symptoms -vomitting -abdomen distention -abdominal pain
Tumors in the stomach
Benign tumors are rare Incidence of cancer varies by geographic area, race, diet, heredity, and sex Pain is not an early symptom, so diagnosis usially occurs late sstage Prognosis depends on stage - Bleeding - vomiting - loss of apetite - weight loss - Early satiety
Bifid collecting system
Each kidney has two ureters and two pelvises increased risk of infection and renal calculi
Diverticula
Ureteral diverticula -demonstrated by retrograde urography Bladder diverticula -congenital or result from obstruction/infection Ureteral valves -congenital mucosal folds in male urethra can obstruct urine flow
Foreign Bodies
foreign bodies may be radiopaque or radiolucent radiopaque is often seen w/o aid of contrast radiolucent is best seen w/ barium swallow Two projections 90 degrees from each other is truly required to determine location
Vesicoureteral reflux
when the vale between ureter and bladder not functioning properly Urine is pushed from bladder to kidney Urine may be infected and can result in UTI Tx: time meds surgery
Reflux Esophagitis
Primary cause of esophageal inflammation -GERD - gastroesophageal reflux disease Chronic Esophagitis may result in stricutres or barretts esophagus
Barretts disease
When chronic reflux has eroded the normal squamous lining and replaced it with tissue similar to the stomach (pre-cancerous)
Esophageal Varices
Dilated veins in the distal esoghagus Commonly caused by increased pressure in the portal venous system (frequently portal hypertension is usually caused by cirrhosis) Common cause of UGI bleeding Varicose veins of distal esopagus Can be caused by strenuous vomiting and common w/alcohol issues "coffee ground" emesis - dried blood Backflow and pooling of veins in esopagus "beaded necklace appearance" Symptoms: hemoptysis Pain
Hypertrophic Pyloric stenosis
congenital anomaly of the stomach where the pyloric canal is greatly narrowed because of hypertrophy and hyperplasia Most common surgery indication for infants Symptoms: Bile-free emesis at 2-6 weeks old Dehydration Failure to gain weight Can be palpated - often described as a mobile, hard, olive
Ureterocele
dilatation of ureter near bladder insertion, caused by stenosis of the ureteral orifice "Cobra head appearance"
Crohn disease (Regional Enteritis)
Chronic inflammatory disorder of all layer, with Unknown cause Genetic predisposition Affects males/females, 14-24, 50-60 Sympoms similar to appendicitis or acute bowel obstruction,May lead to mechanical bowel obstruction Involves all layers of the bowel wall, string sign or cobblestone appearance Diseased parts of bowel are seaparated by sections of healty bowel "skip sections" Begins at terminal ileum and cecum "descends" Periods of exacerbation and inactivity ->> Reoccurs frequently , so no surgery
Ectopic Ureterocele
appears with ureteral duplication Substantial obstruction -renal failure
Hypertrophic pyloric stenosis - Upper GI Study
Delayed gastic emptying -barium-filled antrum Filling of proximal pylorus (beak sign) Enlongated pylorus (string sign) Trx. pyloromyotomy
Volvulus
Twisting of bowel loop Usually at the sigmoid or ileocecal junction -most common in older adults -appears as air in shape of dilated bowel - some wil resolve on their own, but if more than 360 degrees, need to prevent necrosis
Diverticulosis
Diverticula w/o inflammation Condition of acquired herniations of mucosa and submucosa through muscular layers at points of weakness if the bowel wall Through out colon, common in sigmoid Affects 35-50% of pt. over 50 "Saw tooth " appearance
Cystitis
Inflammation of the bladder -common -especially for indwelling catheter -needs to be treated Tx: antibiotics, push fluids to flush infection away
Achalasia
Failure of lower esophageal sphincter to relax - occurs equally in men and women - most common in ages 20-40 yrs. of age ->>>>result in dyspagia -Dilated proximal esophagus -Beaked appearance of distal esophagus -small spurts of contrast will pass through Treatment: -esophageal dilitation - medications to reduce sphincter pressure -chemical denerviation -surgery - myotomy - cutting sphincter muscle fibers
Gastritis
Gastritis is defined as inflammation of the stomach mucosa Causes: NSAIDS Alcohol Steroids stress or trauma Infection: H. Pylori Salmonella Acute or chronic Fluid management treatment nausea releife Elimination of causative agent Antibiotics acid-reducing medications
Perforation of the esophagus
May be a complication: Esophagitis peptic ulcer neoplasm external trauma instrumentation
Ectopic Kidney
Kidney that is a different place than it is supposed to be Often asymptomatic Could be up in thoracic cavity or in pelvis
Zenker's Diverticulum
Pulsion type Upper esophagus Posterior aspect
Intussusception
Coiled spring appearance Common at the ileocecal valve -more common in infants and children -often reduced by ENEMA Adulst- signifies intraluminal mass - surgery Telescoping of a segment of the intestine
Paralytic Ileus
Fluid and gas do not progress through an non-obstructed small or large bowel Also known as Dynamic Ileus More common than mechanical obstruction Caused: -Surgery(almost all abdominal surgery pts. to some degree) -Infection, peritonitis -medications that lower intestinal peristalsis -electrolyte and metabolic disorders -trauma or stressful illness Symptoms: Abdomen distention Cramping vomiting Gas and fluid seen w/in both SB and LB Treatment: May resolve on its own Nasogastric suction Medical stimulation of bowel
Esophageal Cancer
Diagnosed by barium swallow, endoscopic biospy Thought to be caused by chronic irritation Primary symptom is dysphagia - may not be significant until after metastatic spread has already occurred
Urinary system calcifications
Second only to gallbladder for stone formation -renal calculi -more common in males after age 30
Section 7
(50 cards)
Cholecystitis
Acute inflammation of the gallbladder -sudden onset of pain, fever, nausea, and vomiting -common in patients w/chronic obstruction -clinical presentation along w/sonography or cholescintigraphy assists w/diagnosis Complications: rupture fistula gallston ileus (impacted in small bowel)
Renal failure
Acute is less common Chronic: -chronic glomerulonephritis -PKD (Polycystic Kidney Disease) >normal function is impaired >uremia (decreased urine output) Tx: Dialysis Transplant
Hydronephrosis
dilation of renal pelvis an calyces w/urine can lead to ischemia, atrophhy, and loss of function Its okay if it can drain
Pancreatic Cancer
rapidly fatal 5th most common dificult to diagnose due to location and lack of symptoms prior to spread Risk factors: smoking alcoholism chronic pancreatitits diabetes mellitus family history of adenocarcinoma MOst common site is at the HEAD of the pancreas, which is difficult to assess and treat May be visible on barium studies of stomach and small bowel, but best seen CT tx: radical surgery - hiogh mortality rate radiation therapy - still high mortality rate
Gallbladder
stores and concentrates bile produced in liver Receives bile from hepatic duct, then empties bile into duodenum to aid in digestion
Pancreatitis
Acute pancreatitis is an inflammatory process in which trypsin (a digestive enzyme) becomes activated w/in the pancreas and begins digesting the organ itself Caused by: excessive alcohol consumption gallstones or tumor obstructing bile flow ERCP contrast media Complications hemorrhagic pancreatitis psudocyst can form symptoms: mild abdominal pain vomititn severe pain shock Radiographic appearance -subtle -displacement o duodenal C-loop of stomach -calcified stones in pancreatc or biliary ducts LAB testing is the most common way to diagnose Tx: pain meds to manage pain maintaining proper fluids dietary restriction - no alc surgery is controversial prognosis excellent for mild cases severe cases - bad
When stones are present , what radiographs
Abdominal raditograhy -IVU -retrograde pyelography US CT - stone study-non-contrast *gold standard
choleilithiasis (gallstones)
May be singular or multiple Most are radiolucent May need to be disinguished from renal stones if seen on radiographs Small stones may travel into the biliary tree and cause obstruction (pain, jaundice, cholangitis) Tx: surgical removal
Cystography
Studeis the lower urinary tract Catheter is inserted into the urethra to fill bladder w/contrast material Looking for: -vesicoureteral reflux -congenital anomalies -tumors and diverticula -calculi -bladder ruptrue -neurogenic bladder Voiding cystography is antegrade
Hepatitis D
Can only occur w/ HBV
Primary method of visualizing the parenchymal structure and renal pelvis of the kidney
sonography
Fatty Liver Disease
Factors that contribute to non-alcohol related fatty liver disease: -Type 2 diabetes -metabolic syndrom -hyperlipidema Tx: Weight loss and exercise program trx 4 insulin resistance and metabolic disturbances
neurogenic bladder
damage to the nerve that controls the bladder
Carcinoma of the gallbladder
infrequent most gallbladder neoplasms are malignant more common in women and older adults w/ gallstones present symptoms: -nonspecific -RUQ pain -Jaundice -weight loss Imaging consideratiosn: -radiographs may demonstrate a mass replaceing the gallbladder, polypoid mass w/in the gallbladder , or thickening of gallbladder wall -CT and US are the best imaging methods for gallbladder carcinoma (most die w/in 1 year)
Hepatitis
Hepatitis is the most prevalent inflammatory disease of the liver Hepatomaglaly on radiographys Goal is prevention , some treatment, HAV is the one that can be treated by meds -typically caused by viral agents HAV HBV HCV etic.
Urinary calculi vs. phlebolith?
Phlebolith - round calcification in a vein Common on the left side, and in women 50% of population has, and increases w/age inconsiquential
Liver has a double supply of blood from
the hepatic artery and portal vein
Urinary system stones
Are usualy asymptomatic until stone descends or causes obstruction - renal colic (if the stone gets caught in the junction, severe flank pain) - 3 points of obstruction (ureteropelvic junction, pelvic brim, ureterovesical junction)
Ascites
fluid accumulation in the abdomen -Cirrhosis can cause
Hepatocellular Carcinoma (Hepatoma)
Primary liver cell cancer -may be associated w/ cirrhosis, chronic hepatits B/C, and alcoholism -CT is modality of choice -Radiograph shows hepatomegaly Sympotms: -unexpected deterioration in cirrhosis ppl -increased jaundice -abdominal pain -weight loss -RUQ pain -Ascites -hepatomegaly
Metastatic Liver Disease
Hepatic metastasis are more common than primary malignancies due to liver's role in filtering the blood -imminent death Medication to shrink tumor size and for pain relief are used
Splenic rupture
most commonly caused because of Trauma -rapid blood loss requires immediate surgery It may be a complication of the palpation of a spleen enlarged by infection
Splenomegaly
Enlargement of the spleen Assoiciated w/many conditions: Infections Connective tissue disorders NEoplastic hematolgic disroders Hemolytic anemia hemoglobinopathies portal hypertension (cirrhosis)
Imaging mode of choice for gallbladder and biliary tree
Sonography - also can be used to evaluate liver, also, there would be an x-ray taken first CT good for malignancies, obstructions NUc med - SPECT for lesians MRI in conjunction w/CT
Hemangioma
MOST common liver tumor Benign composed of newly formed blood vessels usually insignificant, may cause RUQ pain malignancy is rare- can be accessed/monitored by CT/MRI
Polycystic kidneys
inherited disorder multipile cysts on kidneys, that gradually enlarge w/age 30-35% of patients also have liver cysts 50% are iagnosed w/ renal hypertension 50% develop uremia -dialysis or transplant
Retrograde Pyelography
Catheter is placed in the ureteric orifice -contrast is injected retrograde directly into the ureter to study the renal collecting system indications: hematuria -hydronephrosis -kidney obstruction
Hepatocellular adenoma
Benign typically asymptomatic most commonly seen w/contraceptive use liver
Hepatitis E
water-borne acute hepatitis outbreaks -related to hepatitis A, happens in developing countries and dosesnt progress to chronic stage
Bladder carcinoma
Predominantly men over 60 Factors: Cigarette smoking Industrial chemicals Symptoms: Painless hematuria Slow growing IVU or cystography - filling defect may be seen Diagnosis made through biospys CT/US and MRI useful Tx: Transurethral resection chemotherapy Resection or cystectomy bladder removal - ureters transplanted into loop of ileum.
Percutaneous nephrostomy
catheter is inserted directly into renal pelvis under image guidance -drainage/stone removal, immediate obstruction relief
Hepatitis C
Occurs when blood from an infected person enters the body of a person who is not infected (blood transfusion) may cause acute or chronic hepatitis
Pneumoperitoneum
Free air in the abdomen/peritoneal cavity causes: After a procedure, perforation of a gas-containing Abdominal,gynecological , etc
cystitis
very common indwelling foley catheter can cause further problems if not treated
Porcelain Gallbladder
Calcification of the gallbladder walls, caused by chronic cholecystitis (walls become fibrous then calcify) -approx. 22% of pts. w/this condition develop carcinoma tx- remove gallbladder
CT & kidneys
kidneys can be visualized w/or w/o contrast -helps distinguqish solid and systic masses contrast is useful when evaluating urinary system
Pancreatic Psuedocyst
walled-off fluid collections due to : inflammation necrosis hemmorages casued by : acute pancreatitis trauma
ectopic kidney
located outside of the normal position, most often in the pelvic cavity
Staghorn calculi
urinary calcification, It fills the renal pelvis and looks like horns, it can fill the whole area and that kidney will not function tx: SWL-shock wave licotripsy Open incision
Intravenous Urography
Indications: Obstruction abnormal sediment Hypertension Requires contrast administration -timed series of images taken to demonstrate various sections of collection system
Hepatitis A
inflammation of the liver spread by fecal contamination of food or water most common form of hepatitis highly contagious duration is short and mild doesnt cause long lasting liver damage *seen in developing countries especially
Nephroblastoma (Wilms Tumor)
Peds - diagnosed prior to age 5 Approx. 500 cases annually Occurs w/individuals of african descent and slightly more common in girls Asymptomatic CT- best modality to assess tumor and extent Staging is critical: -high cure rate fro stage 1-3 -otherwise if lett, will metastasize quickly
Hepatitis G
transmitted via blood products, may cause chronic hepatitis
Renal Cysts
half of the population over 50 have renal cysts Can be solitary, multiple, or bilataeral typically asymptomatic, do not impair renal function Demonstrated by nephrotomography and US incidental finding
Cirrhosis
Chronic destruction of liver cells and structure, w/nodular regeration of liver parenchyma and fibrosis (asymptomatic in early stages) End stage condition from -chronic alcoholism -drugs -autoimmune disorders -metaboic and genetic disease -chronic hepatitis -cardiac problems -chronic biliary tract obstruction Complications of impaired liver function: Jaundice - bile collecting portal hypertention - esophageal varices -Ascites (fluid accumulation in the abdomen) Causes us to increase technical factors
Alcohol-Induced Liver Disease
Alcohol metabolism causes cellular damage, so chronic alcohol abuse can lead to a fatty liver Complications: hepatomagalyh Hepatitis Cirrhosis Hepatocellular carcinoma
Renal angiography
further evaluate malignant masses embolize blood flow to a mass assess renal artery stenosis evaluate vascular disorders or congenital anomalies Catheter injected in peripheral artery and contrast injected into renal artery or abdominal aorrta to demonstrate vasculature
Renal Cell Carcinoma
Most common malignant kidney tumor -originates in Proximal conviluted tubule -more common in men and populations over 50 y/o Symptoms -flank pain -fever -palpable mass Visualize w/ CT <BEST Readily metastasize !!! w/lmph node connections Tx: nephrectomy chemotherapy radiofrequency ablation
Hepatitis B
Spread by exposure to contaminated blood or blood products Longer duration and more sever than HAV May remain asymptomatic or develop complications -acute/chronic hepatitis -cirrhosis -hepatocellular carcinoma Healthcare workers required to get vaccine
Hyrdonephrosis
Dilatation of renal pelvis and fills with urine cause it cant drain down There is an obstruction in the ureter leads to ischemia, atrophy, loss of function Caused by: Calculus congenital Tumor stricture blood clot inflammation Symptoms flank pain, blood or pus in urine Caught early, is reversible Imaging: US Doppler US (seeing bloodflow) CT - 90% diagnosis
Section 8
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